Post-menopausal bleeding clinic at Spire Harpenden Hospital

The One-Stop Post-menopausal Bleeding (PMB) Clinic is aimed at women both before and after the menopause who experience abnormal bleeding.

This service is run by two gynaecology specialists - Mr Alasdair DrakeMr Owen Owens.

Mr Drake’s clinics take place on a Wednesday evening. Mr Owens’ clinics take place on a Saturday morning. This helps to ensure that all patients can be seen speedily and conveniently.

Why should I see a specialist?

You would be referred to this clinic by your GP because of your abnormal vaginal bleeding. It is important that all women who experience vaginal bleeding after the menopause are assessed to help establish the cause.  For most women there is a simple explanation that usually needs little or no treatment. In some cases your GP may refer you for assessment to exclude the small possibility of something more serious - such as cancer.

What is post-menopausal bleeding?

Post-menopausal bleeding is any vaginal bleeding after the menopause.  It is assumed you have gone through the menopause if you have not had a period for at least six months. If you are on HRT this may cause you to have bleeding like a period. Abnormal bleeding on HRT or before you have gone through the menopause may also need to be investigated.

What causes post-menopausal bleeding?

Most post-menopausal and other abnormal bleeding is caused by a change in your hormones and usually needs no treatment. Sometimes it is caused by something simple such as a polyp that can easily be removed.

However, a significant cause of bleeding can be cancer of the uterus (endometrial cancer) or the cervix - although in fact only about 1 in 10 women with this symptom have such a serious diagnosis. Obviously it is important to find these conditions quickly as early treatment is often curative.

How does the clinic work?

During your visit to the clinic you will see two consultants one after the other. First of all you will see a Consultant Radiologist for a scan followed by a consultation with either Mr Alasdair Drake or Mr Owen Owens (your confirmation letter states which gynaecologist your appointment is with).

Both Mr Drake and Mr Owens are Consultant Gynaecologists and are experienced in assessing and treating the causes of abnormal bleeding. Both are recognised experts in this field.

Dr Sue Buckingham and Dr Jill Wilkie are both Consultant Radiologists. They are experienced in diagnosing and assessing the causes of abnormal bleeding using scans.

The aim of the clinic is to complete all the tests you need in one visit, although this may not always be possible.

Pelvic Ultrasound

Patients should expect to be in the scanning department for 20-30 minutes. A full bladder is required.

The first scan uses an ultrasound probe placed on the abdomen with some jelly. This shows the uterus and ovaries.

After this scan you will be able to go to the toilet and empty your bladder.

A second scan is then performed using an ultrasound probe placed gently into the vagina. This should not hurt, but may cause slight discomfort for some women. For most women it is far less uncomfortable than having a cervical smear.

This scan gets closer to the uterus and allows the doctor to accurately see whether there is any thickening of the lining of the womb (endometrium) and to look more closely at the ovaries.

Endometrial sampling

Endometrium literally means “inside the womb”. A sample of tissue (biopsy) can be taken from the lining (endometrium) inside the womb (uterus) using a thin plastic pipe passed through the cervix. It feels rather like having a smear test and can feel uncomfortable like period pain. There is no “cutting” involved, it takes 30 seconds and is very safe.

What happens next?

We hope to be able to reassure patients at their first visit though a follow up appointment may be necessary. We will explain the results of all the tests you have. The results of any biopsies taken are likely to take a week or so to come back. as they need to be looked at under a microscope by a pathologist. Sometimes it will be necessary to arrange other tests such as further scans or hysteroscopy under general anaesthetic. The consultant will discuss whether there is any need to come back for another appointment.

To find out more about this service please contact the hospital by phone 01582 714 420 or email us at